Applying Six Sigma in Duke Hospital

Applying Six Sigma in Duke Hospital

The aim of every organization in the world today is to have a good relationship with the customers it serves through implementing processes that ensure customer satisfaction is enhanced. To enhance customer satisfaction in an organization, it means improving and maintaining quality in the products and services championed in that organization. Quality of service is the leading factor that ensures customers are satisfied in an organization.

Six sigma isa technique applied in organizations to reduce defects on the products or services produced by an organization. Six Sigma can be applied in every organization in the world today even though it was only implemented in the manufacturing sector. This paper aims at analyzing the quality of service applied in the Duke University Hospital and how six sigma can be used to enhance the quality of service in the hospital. The hospital is located in Durham, North Carolina in the United States where it is integral to Duke University. The hospital has a good reputation for the quality of service it offers to patients but fails to reach the par of its competitors.

The hospital is ranked seventh in terms of quality among the 5,462 medical centers in the United States. Despite this top rank in healthcare services, the hospital can achieve more scores by implementing six sigma strategies in all of its processes and services. The hospital falls under the health system of Duke University which is comprised of the Duke University School of Nursing, the Duke University School of Medicine, the Duke University Clinic, and other member hospitals.By integrating the six sigma approach the hospital can the current problems that it faces and improve customer satisfaction and retention.

Background

Healthcare today is faced characterized by complexities and contradictions to serve patients. The health care system is usually seen to implementtreatment using the latest technologies and procedures but due to inefficiencies, resource constraints, errors and other issues the whole system is overburdened resulting in poor service delivery. In 1998, a report compiled by the Institute of Medicine articulated that over 98,000 people perish every year as a result of poor health care and errors that are associated in the healthcare system thus highlighting the need for quality improvement (Lazarus & Neely, 2003).

According to reports, about $2 billion are spent every year as a result of clinical compensation due to clinical errors (Milligan & Robinson, 2008). The key motivation for the healthcare system to operate more efficiently is the continuous reduction in reimbursements from the government. The reduction in reimbursements and supplies has made medical organizations to find another way of solving the crisis which is mainly on improving the current way of operation to reduce extra costs.

To solve the crisis in the Duke Hospital, the best idea to implement is through re-examining the current procedures and processes in the hospital and ensure that there is an improvement in:

• Efficiency
• Clinical outcomes, and

In healthcare setup, patient satisfaction is the key measure of the quality of service which mainly determines the long-term success of a healthcare organization. For a healthcare organization such as the Duke University Hospital, the management and healthcare providers should focus on strategies that improve the quality of service. Six attributes are associated with a quality health care system includetimely, safety, patient-centered, equitable, effective,and efficient.

Emphasizing on the above quality attributes is a crucial thing in improving the healthcare quality in the hospital.

To achieve the quality of service in the Duke University Hospital, the main focus should be on imposing quality to the processes and procedures in the system rather than optimizing the healthcare. That is, the hospital should focus entirely on analyzing the current procedures in achieving quality rather than introducing other strategies that will result in additional overhead costs for the hospital.

Six Sigma methodology is a tool that can be implemented to optimize the quality of service in the Duke’s Hospital Healthcare system. A methodology is a powerful tool that when well implemented can result in the delivery of services that are near-perfect or without errors.

Application of Six Sigma Methodology in Duke University Hospital

To improve the quality of healthcare service in the Duke Hospital, the following areas are to be implemented using six sigma methodology:

• Decreasing waiting time for surgeries:Normally, patients usually register their dissatisfaction as they wait in queue for surgery. The major response from the patients is that the process for waste a lot of time thus creating a lot of distress to both the family and the patient.From the hospital perspective, the increased waiting time for patients undergoing surgery causes extra usage of resources, increases risks to patients, and increase wastage of resources.

To solve this problem, a quality improvement team should be formed to analyze the process involved before surgical patients receive their service and the main focus is on addressing the nodes in the process that results in delay and time wastage. To visually understand the whole chain of occurrences, the improvement team should develop a flowchart of events from the time the patient is admitted to the time of receiving surgery.

After developing a flowchart of events, the team should then design a fishbone diagram to analyze the points in which time is lost in the whole process. Relevant data is collected through modification of the medical record to analyze the main areas where time was lost in the process. The recorded nodes where time is lost are then indicated and an explanation recorded with the help of a medical attendant. On average, the main cause for delay is the many laboratory tests performed where time is wasted awaiting results.

• Improving MRI Image Quality:As mentioned earlier in this paper, the healthcare sector is characterized by improved complex and complicated technologies. For instance, several imaging technologies are invented and deployed in the healthcare sector regularly. The imaging technology is utilized by physicians to analyze a specific problem so that they can generate accurate conclusions for diagnosis (Usmani et al., 2011).

It, therefore, means that accurate imaging leads to accurate treatment while poor imaging proves the vice versa is correct. To build confidence in the diagnostic and treatment of patients by the physicians, the hospital should redesign the process of imaging for better results.

In cases where imaging is used in diagnosis, there is always the risk of variation since the output can be interpreted differently by different members of the diagnosis team. To reduce the errors resulting in this variance, the six sigma technique can be used to improve the quality of imaging.

The imaging quality of MRI is a variable determined by several factors including processing conditions, technical variables, observer’s performance, equipment calibration, etc. The main contributing factor is the biasness of the observer which can be eliminated through training. Other parameters that lead to this problem can be mitigated through training of the technical operators of the equipment and providing maintenance services to the MRI equipment.

• Decreasing unnecessary laboratory tests:many tests involving blood and urinary tests are done several times repeatedly to enhance accuracy in the processes of diagnosis for the infection. The human errors are a major cause of poor servicedelivery which is dependent on several factors that require addressing. In Duke hospital, for instance, a quality improvement team should be created to analyze the background factors inhibiting proper laboratory tests.

The current setup consumes a lot of time the which results in wastage of resources and poor diagnosis. To well analyze this root cause, a six sigma methodological approach should be employed to increase the quality of tests done in the hospital. A flowchart should be developed to represent the processes undergone in the laboratory tests which will represent the basic steps followed in doing the tests before the patient’s treatment. After the flowchart of events is finalized, the development team should then utilize the fishbone diagram to speculate the causes of errors and the possible nodes where time is wasted.

Tools to be used to implement the six sigma in Duke Hospital

Flowcharting

Flowcharting is a basic way of representing a process from the beginning to the end showing all the steps involved to achieve results. Flowcharts provide a visual interpretation of the processes involved hence equipping the analysts with enough information to make reports. Flowcharting will be used in visual steps of the processes involved in the hospital which will then be used to analyze the causes of errors for necessary amendments.

Fishbone Diagram

A fishbone diagram will be used to advance the report of the flowchart diagram. The tool will be used as a brainstorm to analyze the causes of specific events as specified in the flowchart diagram. For example, in the case of reducing the waiting time for surgery, the fishbone will be used to analyze the specific causes of the delay in the process.

Conclusion

Six Sigma is a methodology used in organizations to boost the quality of service is availed to customers. In the healthcare sector, the quality of service to patients is preferred most rather than the quantity of care. The Duke Hospital is an example of a healthcare organization that is in dire need of quality improvement to enhance the quality of care to patients while avoiding costs and errors. The process of improving the quality of care in Duke Hospital will involve analyzing the current procedures and processes to identify the key areas of improvement. To actuate this process, the quality improvement team should utilize the flowcharting and fishbone diagram to speculate on the causes of errors so that the relevant mitigation strategies to implement.

 

References

Lazarus, I. R., & Neely, C. (2003). Six sigma raising the bar. Managed Healthcare, 13(1), 31-31

Milligan, F., & Robinson, K. (2008). 13. Limiting Harm in Future Health Care±The Role of Nursing. Limiting Harm in Health Care: A Nursing Perspective, 255

Usmani, N., Sloboda, R., Kamal, W., Ghosh, S., Pervez, N., Pedersen, J., … &Monajemi, T. (2011). Can images obtained with high field strength magnetic resonance imaging reduce contouring variability of the prostate?. International Journal of Radiation Oncology* Biology* Physics, 80(3), 728-734

 

 

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